Presented by: Mahmoud Elmousili MBBCH
Wythenshawe Hospital, Manchester Foundation Trust

Introduction

Documentation is essential to clinical practice, and proper catheterisation procedure documentation ensures continuity of care and effective handover among healthcare professionals. This project looked at the documentation at the A&E department and its impact on patients passing or failing TWOC.

Materials

Data were collected retrospectively from August to December 2021. 70 patients were included in the 1st cycle. Inclusion criteria included male patients who presented to A&E with acute/chronic retention, difficulty in changing catheter by district nurse (DN), haematuria and other catheter-associated problems. Female patients and patients who were admitted to the hospital were excluded.   

Results

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The QIP found that 19% of patients had no documentation for PV bladder scan, and 69% had no DRE done. Nearly half of the patients hadn’t had the type or size of catheter documented (59 & 52%, respectively). Only 31% of catheter introducers registered whether the catheter insertion was easy/difficult, while 11% provided their patients with Catheter Passports. Post catheterisation, 35% of the patient had no Tamsulosin/Finasteride prescribed; 17% failed TWOC, while the chances of successful TWOC increased to 35% with a prescription of Tamsulosin/Finasteride. Most patients who failed TWOC have no documented catheter type (14%). Moreover, the incidence of failing TWOC was higher in patients with latex catheters (4%) in comparison to silicone catheters (2%). Referral to TWOC clinic was missed in 10%, while DN referral was not done for 31% of patients.

Conclusion

There is clear evidence that the lack of proper documentation for the procedure has adverse outcomes for the TWOC clinic. Awareness among junior doctors, and nurses should be increased regarding standardised documentation. Moreover, a smart phrase integrated into HIVE can be a plausible solution.

Funding

Non applicable 

Lead Authors

Thiru Gunendran, MBBCH
Manchester Foundation Trust